DRIVEWAYMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Requ
Dat: • ) lU3 Time
Type Insp'n
Permit No.
Name �1Z •
Address
Company C3�1 M Q�
go) - ar)(1
For Inspector: ' l 13 ) & Date
Approved
Correction
Re- Insp'n Fee
o
Issue Date: 5/4/2006
Owner's Name: CARRIE MUTTER
Permit Type: Driveways /Sidewalks /Slabs
Work Classification: New
Job Address: 309 99 Street NE
Additional Information
Miami Shores Village, FL
Comments:
NEW 3' x 6' CONCRETE SLAB FOR GENERATOR
Building Department File Copy
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 10/23/2006
Contractor(s) Phone
TCS CONTRACTING CORP (305)919 -7761
Primary Contractor
Yes
Type of Work: SLAB FOR GENERATOR Additional Info:
Bond Return :
Classification: Residential
In consideration of the issuance to me of this permit, I agree to perform the work
covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications
submitted to the proper authorities of Miami Shores Village. In accepting this permit I
assume responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: DS -4 -06 -1067
Phone: (305)790 -1480
1132060135490
Lot:
PB:
Total Square Feet: 15
Total Valuation: $ 400.00
Required Inspections
Foundation
Sidewalk
Landscaping
Final
Fees Due
CCF
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$30.00
$2.50
$133.30
Invoice Number
DS - 5 - 06 - 24711
Total:
Amt Due
$133.30
�f'flyt.
NAY 16 PAID
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Inspection Number: INSP - 15858 Permit Number: DS -4 -06 -1067
Inspection Date: 12/07/2006
Inspector: Grande, Claudio
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: TCS CONTRACTING CORP
Buildin4 Deaartment Comments
Wednesday, December 6, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
DEC 11 BIN
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: (305)919 -7761
Page 1 of 2
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP - 15858 Permit Number: DS -4 -06 -1067
Inspection Date: 12/07/2006
Inspector: Grande, Claudio
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: TCS CONTRACTING CORP
Buildin4 Deaartment Comments
Wednesday, December 6, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
DEC 11 BIN
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: (305)919 -7761
Page 1 of 2
SLAB FOR GENERATOR
Passed
Inspector Comments
AtV
6
Cr �
ee'42(64)
le) /
(�,
Failed..
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 06/28/2006
Inspector: Grande, Claudio
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: TCS CONTRACTING CORP
Building Department Comments
Tuesday, June 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JIIN 2 9 EHT'D
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Foundation
Work Classification: New
Block:
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: (305)919 -7761
Page 2 of 2
-„
\ .(1j\
r�\ ` d
BUILDING
TenantfLessee Name
City 1/11 A AA } h D
Job Address (where the work is being done)
Value of Work For this Permit $
Type of Work: (Addition
Describe Work:
, , r+s1.3
NO INV Latina.
* * * * * * * * * * * * * * * * * *
Bond $ Code Fnforco $
Miami Shores Village
uilding Department
PERMIT APPLICATION APR
FBC 2004 BY:.
10050 N.E.2nd Avenne, Miami Shores, Florida. 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Builder : Electtrica Plumbing l ecbaiiical Roofing
Owner's Name (Fee Simple Titleholder) 1-7 V‘Pirl'y M a TW Phone # ' O — — 1 4 4 0 0
Owner's Address 3 c i NO. q
State r
City Miami. Shores Video qty . psi - Dade
FOLIO i PARCEL # 1i 2 b 13 PAD
Is Building Historically Designated YES NO ,
�" .
Contractor's Company Name TC. S C a n t c (�� 1 r
Contractor's Address , • , I (0 2 3 . No- 1 �i R''r'i-
City hi *44 .--.4~ PL- ziP /11(4 2-
3a,r - - ? .)
Qualifier Name I 7"M' I SA1 t Tw"— Phone #
State Certificate or Registration No. ` C . 6 ( l 3/ Certificate of Cotapetenc No.
Arehitectl .Engineer's Name (if applicable) -1 0 Argil `'/ Phone
d`
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning v Radon $; DPBR $
�f�EI
I�'lIE
2.
re
WOOS
Permit No.
Master Permit No.
Zip 3'313
Phone #
3o -11 )-
Square J Linear Footage Of Work:
Double Fee $
Structural Review. $ Total Fee Now
Phon 3c g1
0 Repair/Replace
CCF $Ot C4
Technology Fee $ `
See Reverse side
�D
•
ZaningS
ties i3 .3
Bonding Company's Name (if applicable) 1 `
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachm Also, a certified copy of the recorded notice of commencement must b osted at the job site
for the first inspection which cu s seven (7) days after the building permit is issued. In the Absence o ' su h posted notice, the
inspection will not be ap. - .v - dand r r inspection fee will be charged
Signature
Signature
Contractor
The foregoing instrument was acknowledged before me this 2 . 4 The foregoing instrument was acknowledged before me this Z
, day of Pr ry f' I' 1 by T c5 it $ i k h
to me or who has produced who is per .nally known e or who has produced
As identification and who did take an oath.
NOTARY PUB IC:
day of A
who is pe
(Revised 02/08/06)
Sign:
Print: S C•AY
My Commission Expires:
wrier or Agen
APPLICATION APPROVED BY:
, by �� I1, \ 1 -
NOTAR
Sign:
Print:
PUB
IC:
# /
544v /3A
�••� •M.a1NNBOO...o..00....o... u
SEAN BRITT ^�y�.. ♦�� My Commission E xp i res: >N BRITT
F * *sk g 7'i i**' 1�Y�Yet***** 9r9r�Ficicieicic�tie9e�t4e�k4c9e�kivirieic�k�F **sv w * *
Expires 12/0200. &Wires 12/II2009
Sanded Wu (100)432.4254i � � Bal
dad uvu (aooH3z -azs4
Florida NatApn.. One i ,.w
. s....n.w ...... .. FFlorida Notary Assn., Inc
yWoi ( v4
as identification and who did take an oath.
Engineer
Zoning
Inspection Number: INSP -15857
Permit Number: DS -4 -06 -1067
Inspection Date: 06/29/2006
Inspector: Grande, Claudio
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: TCS CONTRACTING CORP
in ... De .
q �
artment Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUN 3 0 ENTD
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Foundation
Work Classification: New
Block:
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: (305)919 -7761
Wednesday, June 28, 2006
Page 2 of 2
Passed
/
Inspector Comments
i
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -15857
Permit Number: DS -4 -06 -1067
Inspection Date: 06/29/2006
Inspector: Grande, Claudio
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: TCS CONTRACTING CORP
in ... De .
q �
artment Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUN 3 0 ENTD
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Foundation
Work Classification: New
Block:
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: (305)919 -7761
Wednesday, June 28, 2006
Page 2 of 2
Inspection Date: 12/13/2006
Inspector: Devaney, Michael
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: KENCO ELECTRIC INC
Building Department Comments
Tuesday, December 12, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
•
OS06
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Generator
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: 954 -427 -3367
Page 1 of 2
Passed
Inspector Comments
/3 �
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 12/13/2006
Inspector: Devaney, Michael
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: KENCO ELECTRIC INC
Building Department Comments
Tuesday, December 12, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
•
OS06
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Generator
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: 954 -427 -3367
Page 1 of 2
PLEASE CALL THE CONTRACTOR AT(305) 790 -1400
HALF HOUR BEFORE DO INSP
Passed
Inspector Comments
1
�
G
�� S
_
` l/ " / 2 2/ vLX"��
r ‘09/•'2.,
Zo
.
Failed
Correction
Needed
/ I A, s
'
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 06/26/2006
Inspector: Devaney, Michael
Owner: MUTTER, CARRIE
Job Address: 309 99 Street NE
Project: <NONE>
Contractor: KENCO ELECTRIC INC
Building Department Comments
Friday, June 23, 2006
Miami Shores Village, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -897
Block:
JUN 2 7 ENTp
06- (461
Permit Type: Electrical - Residential
Inspection Type: Underground Rough
Work Classification: Generator
Phone Number (305)790 -1480
Parcel Number 1132060135490
Lot:
Phone: 954 -427 -3367
Page 2 of 2
MIAMI SHORE& VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date /
Type Insp'
Permit No.
Name (1A Y1�•�A��'
Company
Phone #
For Inspecto¢ /;z/03 Name & Date
Approved
Correction
Re- Insp'n Fee
ri
Date Job Address 3 0 7/v, 7 Tat Tax Folio
Legal Description Historically Designated:
Owner /Lessee/Tenet - s 4701-e -e S & o 4 j /U Mister Permi P200
Owner's Address
Contracting Co.
Qualifier
State #
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305 -795 -2204 • Fax: 305 -756 -8972
Phone 3 75 !-
Address
SS# Phone
Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 550.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one):
WORK DESCRIPTION: rL n d
-Fr,1 r\ 0 h01J5 e _ Co A c r �c
b �{ S4-r.e a
Square Ft. .49 / 2tf
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). 1 certify that
all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required
for all disciplines.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President
My Commission Expires
BUILDING
ELECTRICAL
x.
(RECEIVED
9 j � 1N N d 9 2003
Yes
PLUMBING
v(i-ii.tk 0, J
ri
Estimated Cost (value g 8k)
MECHANICAL
of Contracto
Date ary as to ontractor'ti't`'?i '`•': itirBeckar
y Commission Expire t My Commission D0150048
4,„ SP Expires November 15, 2006
ROOFING
4r
` /, i
Date
ate
FEES: PERMIT 0 > RADON C.C.F a. c TD NOTARY.. 0 (� BOND`S
APPROVED: " s � ' T OTAL D12 0
Zoning C(91/4-3 Building Electrical
Mechanical Plumbing Structural Engineer
11
10
49 ;
9
e
14
1 t7*
17
�j �
. * * ******* * * * *** —COMM. JOURNAL— * *** * ***** * *** * **** DATE MAR -05 -2003 * **** TIME 17:25 * *** ****
STN
NO.
MODE = MEMORY TRANSMISSION
FILE N0. =962
COMM. ONE — TOUCH/ STATION NAME /TEL NO.
ABBR NO.
001 OK a 3057568972
***** * * * * * * * * * * * *** * * * * * * * *** * *** * ** — HAYHURT MORTGAGE— * **** —
LEGEND OF SURVEY ABBREVIATIONS I `` I
A ARC DN*TAMCI cc.c 10N�10
C CALCULATID C L CATCN Mom //
CL.... CLEAR CA. ...
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Dx..,4i1RMAMA W,TI.,..WA1DINITIR
►J... KAT Wax M MlAIpRO
,A....rROrIRfY 1111! COMO COM=MIT.
UP ... IhIL1YYPOLf RD
KUM
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C41... CCMCIIITI 11.01
O.U.1.,...OVIRMIAO UT'
P.C.C... POINT OF COM.I
PAC... POOR OF CO1M
S OO .. rlaa.o
CSI.....o10- D MT*
l
D.L,... onAmenlIASIMMIT
FA FIRS NTDRANT
RAp4-
l.ESAL DESCRIPTION: I �
Lot: 15 d 16 dl THE WEST h. . 11)
Block: 40
Subdivision: M Amended PIat;Of Miami Shores Section 1
According to the Plat thereof 4ts recorded In
Plat Books 10 Par; 1
Public Records of MIAMI -BADE County. Florida.
ADDRESS;
309 NE 99 STREET
MIAMI SHORES, FL 33138
Encroachments Noted; Qkl
LQCATION EKETCN
C ALEI 0
N.E. 100th STREET
in
reD
mOTIA:
AI Y e r.reu r lFr w.rMra okra
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N.E. 99th STREET
LOCATION SKTCH
START = MAR -05 17:23
— HAYHURST MORTGAGE
NOVO... RAT1U%A1. OIDDITIC VIRTICAL DATUM
MAC ... PONT OF RIVIPUM CURVATUR11
RAO ...4401AL
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614.F C11.0 1U41( PEnCE
ss:
END = MAR -05 17:24
PAGES DURATION
002/002 00:00:48
305 857 0030 — ** *** ****
Shoot 1 of 1=
FLOOD ZONE: X
THIS I5 A FLOOD
HAZARD ZONE
THIS I5 NOT A FLOOD
HAZARD ZONE
PANEL. NO.;. 93/7
COMMUNITY #: 120652
DATE OF FIRM: 07/17/1005
RASE FLOOD: N/A
FINISH FLOOR: NIA
LOWEST NIA
ADJ GRADE
4
•
F.NAIL
0.50'
CLEAR
O
LOT 14
BLOCK 40
4' WALL
51
rwr
LOT 10
BLOCK 40
18.4'
a 'Y LOT K 15
n BLOCK 40
(G
0
to
N
0
4.9'
LOT 9
BLOCK 40
125.00' (
90.0'
LOT 16
BLOCK 40
20.00' ASPHALT PAVIMENT
4' WALL
I 11.2 5
9 0 X5.30'
2.20
N.E. 99th STREET
Zo nir1 L ;
A. proved
/i .i
SHEET 2 OF 2
LOT 8
BLOCK 40
H.P.
0 7 ( 1 t 3 ')
LOT 17
BLOCK 40
6' WOOD
FENCE
O
O
1 4.95'
reef
o
0 S
• te r )
r c�T I")
M
tom
THOMAS J. KELLY, INC.
L.B. #6486
SURVEYORS- MAPPERS -LAND PLANNERS
8125 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 779 -3288 BRWD
(786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX
0.10'
CLEAR
A /C.
0 x3.0_ 0.30'
CLEAR
15.00'
F.I.P. / /2*
DATE FIELD WORK
SCALE 1„ = Z O SURVEY NO
OLc 13
0
777
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
Witness(sign and print)
Further, Affiant sayeth naught.
hereby attest that the
(property owner)
attached survey, performed by J� /4... .Ot,c)
(name of surveyor' c s omp
performed on 2- 'P 0 . is an accurate representation of the existing conditions and
date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
SWORN TO AND SUBSCRIBED before me this 1 day of
Affiant is personally known to me, produced
Witness(sign and print)
as identification.
. Angela M - er
+� My Commission 0 0150048
q w df Expires November 15, 2006
Was acknowledged b ore me thi _� day of
.1/1 A
•
Produced
,,,,,,,„,, k„_
Owner
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
/141- S z -J
being the legal property owner, for the property
� � /, c ,i V ' 5 .. 33 / K
Located at: / �� ' � 1 � � - � ` � v
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(W pd pd I have read and understand the following disclosure
Statement, which entitles me to as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two- family residence or a farm out - building. You may also build or improve a
commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not licensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of viewing clerk. The foregoing instrument
who is personally known to me or who has
as identification and who did take an oath.
f or Po Angela M Becker
; My Commission DD150048
n df Expires November 15, 2008
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/12/2003 Page 1 of 1
Applicant: JAMES DE MOLINEUX REX CRAWFORD
Owner: REX CRAWFORD JAMES DE MOLINEUX
JOB ADDRESS: 309 NE 99 ST
Contractor
Local Phone:
Parcel # 1132060135490
a Fees: Description Amount
FEE2003 -3557 Building Fee $70.00
FEE2003 -3558 CCF $2.40
(Y\ FEE2003 -3559 Notary Fee $5.00
FEE2003 -3560 Inpector State Educational Fund $6.00
FEE2003 -3561 Builders Bond $300.00
Total Fees: $383.40
e f Permit Status: APPROVED Permit Expiration: 12/9/2003 Construction Value: $3,800.00
Work: NEW CONCRETE CIRCULAR DRIVEWAY
• JAMES DE MOLYNEUX
305- 754 -0894
501 GRAND CONCOURSE
- MIAMI SHORES, FL 33138 -2464
P AY TOFIE
ORDER T OF
Bank ofAmerica....
ACH FIT 063100277 0 7 . 4/, •
4 C
1:06 300004 71: 0 5 4860 2 Lt. 4611' L0 2 2
Building Permit
Permit Number: BP2003 -947
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE
DATE lF
1022
63 -4/630 Fl
827
$3 3 3 . Yts
DO LA
Premier Bankk ng
i compliance with all ordinances and regulations pertaining thereto and in strict
Miami Shores Village. In accepting this permit I assume responisibility for all work
BY:
Total Fees: $383.40
Total Receipts: $0.00